Abstract:

A newly identified coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the infectious coronavirus disease 2019 (COVID-19), emerged in December 2019 in Wuhan, Hubei Province, China, and now poses a major threat to global public health. Previous studies have observed highly variable alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in patients with COVID-19. However, circulating levels of the cholangiocyte injury biomarker γ-glutamyltransferase (GGT) have yet to be reported in the existing COVID-19 case studies. Herein, we describe the relationship between GGT levels and clinical and biochemical characteristics of patients with COVID-19. Our study is a retrospective case series of 98 consecutive hospitalized patients with confirmed COVID-19 at Wenzhou Central Hospital in Wenzhou, China, from January 17 to February 5, 2020. Clinical data were collected using a standardized case report form. Diagnosis of COVID-19 was assessed by symptomatology, reverse transcriptase-polymerase chain reaction (RT-PCR), and computed tomography (CT) scan. The medical records of patients were analyzed by the research team. Of the 98 patients evaluated, elevated GGT levels were observed in 32.7%; increased C-reactive protein (CRP) and elevated ALT and AST levels were observed in 22.5%, 13.3%, and 20.4%, respectively; and elevated alkaline phosphatase (ALP) and triglycerides (TGs) were found in 2% and 21.4%, respectively. Initially, in the 82 patients without chronic liver disease and alcohol history; age older than 40 years (P = 0.027); male gender (P = 0.0145); elevated CRP (P = 0.0366), ALT (P < 0.0001), and ALP (P = 0.0003); and increased TGs (P = 0.0002) were found to be associated with elevated GGT levels. Elevated GGT (P = 0.0086) and CRP (P = 0.0162) levels have a longer length of hospital stay. Conclusion: A sizable number of patients with COVID-19 infection had elevated serum GGT levels. This elevation supports involvement of the liver in persons with COVID-19.

Keywords: ACE2; SARS‐CoV‐2; cholangiocyte injury; gamma‐glutamyltransferase; liver disease.

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γ‐Glutamyltransferase Elevations Are Frequent in Patients With COVID‐19: A Clinical Epidemiologic Study

Chenchan Hu+9 authors

^{Liver Center and Gastrointestinal Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston MA, United States,}

^{Department of Infectious Diseases, Wenzhou Central Hospital and Sixth People’s Hospital of Wenzhou, Wenzhou Zhejiang, China,}

^{Department of Clinical Laboratory, Wenzhou People’s Hospital, The Third Clinical Institute, Wenzhou Medical University, Wenzhou Zhejiang, China,}

^{Department of Hepatology, No. 2 People’s Hospital of Fuyang City, Fuyang Anhui, China,}

Raymond T. Chung, Email: gro.srentrap@gnuhctr.

Contributor Information.

^{Corresponding author.}

^{Correspondence: Dong Chen, M.D.}
Department of Infectious Diseases, Wenzhou Central Hospital and Sixth People’s Hospital of Wenzhou, 1 Qinzhong Road, Wenzhou, Zhejiang 325000, China
E‐mail: moc.621@zw_gnodnehC,
Raymond T. Chung, M.D, Liver Center and Gastrointestinal Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114
E‐mail: gro.srentrap@gnuhctr,

^{These authors contributed equally to this work.}

This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

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